Nick Zonneveld

This article details a correction to: Michgelsen J, Zonneveld N, Miller R, Stein V, Longpré C, Jubinville M, et al. Navigating a Decade of Integrated Care Research in the International Journal of Integrated Care: How Far Have We Come? International Journal of Integrated Care. 2025;25(3):25. DOI: https://doi.org/10.5334/ijic.9086

The scope of integrated care has evolved and broadened the past decades from specialist pathways to incorporate a more holistic approach. To identify such trends in evidence and knowledge, we analysed published papers in the International Journal of Integrated Care over a 10-year period. From an initial set of 5.075 IJIC papers (2012–2022), 508 articles were selected after excluding several categories such as poster and conference abstracts. As no existing theoretical framework seemed to fit our study aim, we chose to focus specifically on two important areas in integrated care that are known for development; impact measurement and co-production in research. There was an overall growth of published papers in the journal. The papers predominantly feature contributions from Western regions, including Europe, the Western Pacific and the Americas. Results regarding impact measurement showed no clear overarching pattern over time. Engaging the target population as co-producers in the studies is still low (<5%). Although the number of papers increased pointing towards more attention for integrated care, we could not identify any significant growth or advancement in the two crucial areas of co-production and impact measurement in integrated care research. These gaps need to be addressed accordingly in both practice and research.

Introduction: Due to aging populations with more complex care needs and growing workforce shortages, our health systems are increasingly under pressure. As these challenges are complex multidimensional problems, governments and healthcare providers face challenges in addressing these issues individually. To work towards sustainable solutions for the future, a collaborative regional approach is needed. The national ‘RegioKracht’ (Regional Strength) program in the Netherlands aims to guide and support organizations in this transformation, by facilitating and encouraging regional collaboration among healthcare providers, governments and insurers. The program provides assistance and knowledge (e.g. through strategic advisors and dissemination platforms) to the governance groups of more than 66 regional collaborations in both care for older people and people with disabilities. The authors of this abstract are part of the team of researchers involved in this program and will be studying the progression in regional collaboration over a period of three years (2024-2026). To examine collaboration and governance, we have developed a questionnaire based on the frequently cited Collaborative Governance Model by Ansell and Gash (2007). Besides the broader scientific implications of the study, the research is primarily aimed at supporting the actors involved in the regional collaboration. In order to do so, the researchers have worked together with strategic advisors policy and decision makers to co-create a practice informed and practical methodology. Co-design: In this presentation the authors will introduce ‘RegioKracht’ as an example of how qualitative research and lived experience of the actors involved intersect and complement each other in order to catalyse transformation. The presentation will specifically focus on the region Groningen as a case-study, describing the collaboration on regional level and in one regional project in particular: ‘LogeerWonen’. In this project different organisations work together with parents to provide integrated care for children with severe learning disabilities and complex comorbidities. Target audience: This presentation will be of interest to policy and decision makers seeking to learn more about collaboration and governance on a regional level, and how to improve these. Researchers may also find this presentation relevant, because several theoretical insights and methodological applications will be presented Results/contribution: In this presentation we will present: -An overview of the RegioKracht program's structure and design, explaining its components and interventions, -The co-designed measurement tools, methods and instruments, based on the Ansell and Gash (2007) model, used in the RegioKracht study, -Preliminary findings from an initial pilot study in Groningen. -Learned lessons about researching integrated care in a way that centres experiential expertise and the ingredients that are important to make regional collaboration effective. Learnings for an international audience: Since many countries face challenges of aging populations, complex care needs, and workforce shortages, effective collaboration is crucial. Furthermore, in both the study of integrated care and the practice of collaboration, experiential expertise is recognised as being of importance. Therefore it is important to keep learning together about how this can inform choices both in methodology and the collaborative process.

Organising integrated health services beyond domains in interorganizational networks, can be supported by conceptual models to overview the complexity. The Development Model for Integrated Care (DMIC) is a systematically developed generic model that has been applied to innovate and implement integrated care services in a large range of (international) healthcare settings. After a decade, it is important to incorporate new available literature in the model. Therefore, our aim was to update and further develop the DMIC by incorporating the current body of knowledge. A systematic literature review and subsequent stepwise systematic update of the DMIC. The review of the literature resulted in 179 included studies and eventually 20 new elements for the development model, which could be positioned in the nine clusters. New elements address the importance of the social system and community of the client, proactive care during the life span, digital (care) services and ethical and value driven collaboration in interorganizational networks that cross domains. The added elements for integrated care build further on the nine thematic clusters and the model as a whole, expanded with new accents. The renewed model emphasizes the connectedness of care within a larger eco-system approach and inter-organizational networks. The model captures current knowledge which can be supportive as a generic conceptual model to develop, implement or innovate integrated services towards health value in societies. Further, it can serve for healthcare services research purposes to reflect on an monitor developments in integrated care settings over time on multiple levels.

Values are seen as important in both interorganizational networks and wicked problems. However, in both academia and practice the exact implications of these values remain unclear. In this article we examine the role of values in interorganizational networks dealing with wicked problems, by conducting a case study in a pregnancy and childbirth network. Our analysis identified both actor and network values, three value tensions among actors, and a variety of coping strategies to deal with these tensions. The findings indicate that value differentiation in networks should not be only seen as a problem, but also as an important ingredient for the achievement of network goals. Furthermore, our study revealed functional-structural and cognitive-cultural coping strategies to respond to value tensions among actors, applied by both the network administrative organization and the individual actors in the network. Lastly, we elaborate on the position and skill set of the network leader. We leverage these research results to formulate insights and recommendations for network practice.

Background: In the integrated care literature, functional aspects such as organisational forms, improving processes, funding issues and ICT challenges are dominant. However, although a lot has been written about these features, it is still difficult to understand why integrated care sometimes works, and sometimes does not. The scale-up of integrated care and the measurement of its impact therefore remain challenging. By focusing our efforts on structural or process elements, we might underestimate the role of human factors and relationships in integrated care. Concepts as trust, belief and relationship management seem fundamental. It is essential to also include these in our thinking, because after all integrated care is about people and for people. In integrated health care programmes and networks, lots of people with a variety of backgrounds and values work together; relations are key. This workshop provides insight in these “human factors” and lets participants experience the role of underlying values. Why a workshop? A workshop format offers the opportunity to actually perform and experience the values mapping exercise. Both individually and groupwise. Target audience: Our workshop will be of interest to professionals, managers and policy and decision makers seeking to learn more about the role of values in integrated care. Researchers may also find our workshop relevant, because we will use the exercise for data collection and we present several theoretical insights. Workshop structure Welcome and Introduction (10 min) - The importance of normative integration? - Who are you and made you choose this session? Theoretical background (10 min) - What are values? - What does recent research show us? Values mapping exercise (individually, 10 min) Start the exercise with examining your own integrated care values by carefully identifying the values and norms underpinning integrated care. Position the values on the map. The different boxes on the map reflect the importance of the particular value, ranging from ""not important"" to ""very important"". Please take your time; repositioning or shuffling is okay! Reflection in pairs (10 min) Reflect on your values map with your ‘partner’ Discuss possible differences between you and your partner Please explain: why are these values important to you? Could you provide an example from practice? How do you apply these values in your work and collaborations? Plenary discussion: Learnings and takeaways (10 min) Reflection on the exercise; reflections on the role of values, linkage to the introduction/theory, collaborative sharing of experiences What are your takeaways? What golden rules could you formulate? Plenary discussion: Practical applicability (10 min) Discussion about how can we use values and the workshop insights for: How can we use values in network governance? How can values help us in decision-making? How can we use values in accountability? This interactive workshop will be facilitated by: 1) Prof Mirella Minkman, PhD (Vilans and TIAS/Tilburg University, The Netherlands - Role: Chair, theoretical reflections), 2) Nick Zonneveld MSc. (Vilans and TIAS/Tilburg University, The Netherlands – Role: Moderator, reflections)"